Venous thromboembolism remains a leading cause of preventable mortality in intensive care unit (ICU) patients. Existing risk-stratification tools were developed in general medical populations and lack ICU-specific predictors. This study was to develop and validate an interpretable machine learning (ML) model to predict VTE in ICU patients.

Inclusion Criteria:

• age ≥18 years;
• ICU length of stay ≥48 hour
• the first ICU admission

Exclusion Criteria:

• VTE diagnosed prior to ICU admission
• VTE diagnosed within 24 hours of ICU admission
• >20% missing values in key variables

Patients admitted to ICU were included in the study cohort from January 2022 to October 2025. Inclusion criteria were: (1) age ≥18 years; (2) ICU length of stay ≥48 hours; (3) only the first ICU admission per patient was retained. Exclusion criteria were: (1) VTE diagnosed prior to ICU admission; (2) VTE diagnosed within 24 hours of ICU admission; (3) >20% missing values in key variables. The final cohort comprised 12,061 patients, of whom 587 (4.9%) developed VTE during ICU hospitalization.